Provider Demographics
NPI:1558526632
Name:ZIMMERMAN, JAY (BA)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7600 GREENHAVEN DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5604
Mailing Address - Country:US
Mailing Address - Phone:916-665-1804
Mailing Address - Fax:916-665-1807
Practice Address - Street 1:7600 GREENHAVEN DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5604
Practice Address - Country:US
Practice Address - Phone:916-665-1804
Practice Address - Fax:916-665-1807
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)